2007年三峡库区人群日本血吸虫病血清流行病学研究

A study on sero-epidemiology of Schistosoma japonicum of local inhabitants in the Three Gorges Reservoir areas in 2007

摘要目的掌握三峡库区当地人群抗日本血吸虫特异性抗体的分布特征和影响因素。方法选择三峡库区中段6个区县的当地居民为研究对象，用统一的调查表进行个案调查，采集2～3mL静脉血，检测人群血吸虫特异性抗体（IgG）。结果本次调查3003人，人群血吸虫抗体水平几何平均数（OD均值）为0．0172，抗体阳性率为0．87％（26／3003）。男0D均值为0．0159，女为0．0183，性别间差异有统计学意义（F=4．449，P〈0．05）；男抗体阳性率为0．70％，女0．99％，差异无统计学意义（X^2=0．688，P〉0．05）。70岁以上组0D均值最高（0．0245），50～59岁组滴度最低（O．0146），各年龄组0D均值差异有统计学意义（X^2=23．56，P〈0．05），呈正相关（R=0．043，P〈O．05）；年龄组间抗体阳性率差异无统计学意义（X^2=9．553，P〉0．05）。农民和学生OD均值分别为0．0177和0．0161，职业人群闰差异无统计学意义（F=1．115，P〉O．05）。初中和文盲0D均值较高，分别为0．0185和0．0173，学历人群间差异无统计学意义（F=0．760，P〉0．05）。不同收入人群0D均值差异有统计学意义（X^2=3．262，P〈0．05），明显相关（R=0．046，P〈0．05），低收入者（〈3000元）与高收入者（≥3000元）差异有统计学意义（X^2=1．528，P〈0．05）。耕种方式不同人群OD均值差异有统计学意义（X^2=288．58，P〈0．05），牛耕者显著高于机耕者和人耕人群，差异有统计学意义（P〈0．05）。饮用水不同人群0D均值差异有统计学意义（X^2=404．07，P〈0．05），饮用河沟水者OD均值显著高于饮用井水者和自来水者（P〈0．05）。抗体水平全频率分布曲线均呈“L”型，0D均值小于0．04者占64．97％，小于0．08者占92．64％。结论三峡库区人群日本血吸虫特异性抗体水平呈非流行区人群分布特征，人群存在血吸虫病发生和流行的高危行为因素。建议进一步健全三峡库区血吸虫病监测体系，针对重点人群开展健康教育，预防和控制血吸虫病在三峡库区发生和流行。

Objective To analyze the baseline characteristic of anti-schistosome antibody and the hazard factors of infection with S. japonicum of local inhabitants in the Three Gorges Reservoir areas（TGR）. Methods The local inhabitants were investigated in 6 counties of the middle part of TGR. Each case was interviewed by recording data in uniform form. 2-3mL venous blood was drew for study targets and examined by ELISA. Results 3003 people were investigated. The Geometric Mean of OD value（OD-value） of anti-schistosome antibody level was 0. 017 2 and the positive rate was 0.87%（26/3 003）. The OD-value of male was 0. 015 9 and its positive rate was 0.70%. The female was 0. 018 3 and its positive rate was 0.99 %. The OD-value（F= 4. 449, P〈0.05） was significant difference, but the positive rate（X^2=0. 688, P〉0.05） was no significant difference between male and female. The highest OD-value was in the age group of over 70 years（0. 024 5） and the lowest was in 50-59 years（0. 014 6）. The OD-value（X^2 =23.56,P〈0.05） was significant difference among different age groups. There was correlation（R=0. 043,P（0.05） between age groups and OD-value. The positive rate（3（2 ： 9. 553 ,P〉0.05） was no significant difference among different age groups. The OD-value of farmers and students was 0. 017 7 and 0. 016 1. There was no significant difference in OD-value among people with different occupations （F=I. 115 ,P〉0.05）. The OD-value of junior high school and illiterate was 0. 018 5 and 0. 173,but there was no significant difference in OD-value among people with different education background（F= 0. 760, P〉0. 05）. There was significant difference in OD- value among people with different income（X^2=3. 262, P（0.05）. There was correlation（R=0. 046, 〈0.05） between income and OD-value. There was significant difference in OI）value between low（〈3 000 RMB） and high（≥3 000 RMB） level of income（X^2= 3. 252, P〈0. 05）. There was significant difference in OD-value among different styles of farming（X^2=288.58, P〈0.05）. The OD-value of cattle-farming was higher than that of machinery（P〈0.05） and persons（P〈0.05）. There was significant difference in OD-value among different style of drinking water（X^2=404.07,P〈0.05）. The OD-value of river was higher thanthat of well（P〈 0.05）and tap-water（P〈0.05）. The curve of full frequency distribution of antibody level was an ＂L＂ figure. The proportion of OD value under 0. 04 was 64.97%. The proportion under 0. 08 was 92.64%. Conclusion The antibody level against S. japonica infection in the TGR was lower which is same as the level of population in non-endemic region. The potential social-behavior factors affecting schistosomiasis transmission existed. So the monitoring system of schistosomiasis should be improved and health education should be carried out in key populations to prevent infection from S. japonicum in the TGR.